Researchers are beginning to more fully understand who bears the harms of gun violence, but one crucial element is missing—the stories of those who have experienced gun violence firsthand and those who help address the fallout.

That’s why the Urban Institute partnered with Virginia Commonwealth University’s Center on Society and Health and the Engaging Richmond community-based research team to explore the consequences of firearms violence through photovoice and interviews. Engaging Richmond interviewed victims and perpetrators of gun violence in Richmond, Virginia, whose 2012 homicide rate of 20.2 per 100,000 was several times higher than the national rate of 4.7. The Engaging Richmond team, a collaboration between university researchers and Richmond community members, brings the neighborhood perspective to research by documenting the experiences of the families, businesses, and service providers who navigate Richmond’s streets every day. What community members shared aligns with much of the research on the costs and harms of gun violence, and their perspectives offer key insights into what can be done to prevent it.

Kids Can't Be Kids

For many community members, one of most troubling aspects of gun violence is its effect on children.

“Your neighborhood [is] supposed to be safe for you to go out and play,” said one community member. “But now, you know, with all this gun violence, parents [are] scared to let them play . . . kids can’t be kids anymore.”

It’s a valid concern. In one study of urban youth, 42 percent reported having seen someone shot or knifed and 22 percent reported having seen someone killed. Indirect exposure through the sound of gunfire is only now being explored. In DC, a small number of schools were within earshot of a disproportionate volume of gunfire, which may have important implications for the amount of violence students are exposed to outside of school.

The Cycle of Violence

Many times, witnessing—or worse, being directly involved in—that first shooting is only the beginning of a cycle of violence.

“I got the concept,” one survivor explained. “You know, I’d rather get caught with [a gun] than without it . . . I was willing to hurt somebody if they tried to hurt me. Nobody was going to do that to me again.”

Violence Taxes Communities

For gun-violence survivors on the road to recovery, the monetary costs are high. In 2010, inpatient hospital stays for firearm assault cost $14,000 more than the average stay.

But the costs victims face extend far beyond medical treatment. “There are a lot of patients that really need crisis funds because of it,” said one service provider who assists victims of gun violence. “They can’t pay rent, they can’t pay utility bills, phones . . . there’s a lot of immediate financial things that can be impacted negatively because of it.”

More research is needed to understand both the magnitude and type of costs imposed on victims post assault, but at least one measure, lost earnings, suggests that these costs are significant.

“I missed out on life . . . I couldn’t work, I couldn’t get a job because of the severity of the injury . . . It kept me from doing a lot of things,” said one survivor.

Violence can also affect local businesses. As one Richmond business owner noted, “You can’t service many people that you want to service if they’re scared to come in . . . and patronize your business. Because they’re afraid they may get shot.”

So far, no research has developed a precise estimate of the effect of gun violence on community business growth. But business owners in communities with high rates of gun violence certainly feel its effects. “You see a lot of businesses open up and then close a year later because they can’t survive,” one told researchers.

Bad Medicine

To cope with the stress and injury of a gun-violence assault, some victims self-medicate with drugs or alcohol.

“I really medicated myself . . . I was into drugs,” said a survivor. “And I just medicated myself about it. The whole thing.”

This is not a one-off occurrence. Gun injuries and exposure to gun violence are often triggers for PTSD, and it’s not uncommon for sufferers to self-medicate with drugs or alcohol. This coping strategy imposes a variety of new health risks including, most tragically, increased risk of suicide.

A Second Chance

Gun violence presents a number of challenges, but it’s important to remember that these communities are not helpless. In fact, they can be key partners in preventing gun violence and addressing its consequences.

Programs like Cure Violence work to prevent retaliatory violence, mediate conflicts, and encourage communities to rethink the normalcy of violence. They treat gun violence like a disease and use a public health approach, reducing risks and preventing the transmission of violence. This approach has successfully reduced violence in Baltimore, Chicago, and New York.

Addressing the needs of at-risk community members—particularly young people—is another important component of tackling gun violence. Evidence-based programs, like Functional Family Therapy and Multisystemic Therapy, can help reduce criminal behavior by targeting problematic behavior early in life and preventing early violence from spiraling into serious offending.

Another key to addressing gun violence is providing survivors with the tools and resources they need to move forward with their lives. Programs like Prolonged Exposure Therapy have been found effective in reducing the harms of PTSD that can follow exposure to violence.

According to one service provider who worked with gun-violence survivors, “If a survivor comes away with the perception that they’ve been given a sort of second chance or a fresh start, that can be a coping skill.”

Looking Forward

Gun violence imposes a wide array of physical, social, and financial costs on some of America’s most vulnerable communities. Understanding these costs is the first step toward addressing them, and community members who live with the daily presence of gun violence and its fallout can serve as valuable resources. Their insights into the harms associated with gun violence closely align with established findings and offer new directions for further research and strategies for protecting America’s neighborhoods.